Cefdinir vs. cefixime (Suprax) 3rd Generation Antibiotics

• Cefdinir and cefixime (Suprax) are 3rd generation cephalosporin antibiotics used to treat a wide range of infections, for example:
  • Middle ear infections
  • Tonsillitis
  • Strep Throat
  • Laryngitis
  • Sinusitis
  • Bronchitis
  • Pneumonia
  • Skin and soft tissue infections
• Cefdinir and cefixime have similar side effects that include:
  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal pain
  • Headache
  • Vaginitis
  • Skin rash
  • Rarely, abnormal liver tests
• Side effects of cefdinir that are different from cefixime include vaginal yeast infection.
• Rare side effects of cefdinir include:
  • Changes is stool color or consistency
  • Constipation
  • Dry mouth
• Side effects of cefixime that are different from cefdinir include:
  • Fever
  • Joint pain
  • Arthritis
  • Itching
  • Dizziness
• Both cefdinir and cefixime may cause a potentially serious condition called pseudomembranous colitis (Clostridium difficile colitis, C. diff), a bacterial infection of the colon.
• If you are allergic to penicillin-type antibiotics, you also may be allergic to cefdinir or cefixime.
• Rare, but serious allergic reactions to cefdinir and cefixime include:
  • Seizures
  • Anaphylaxis (severe allergic reactions)
  • Low red blood cell or platelet counts.
  • The brand name for cefdinir called Omnicef has been discontinued in the U.S.

Cefdinir and cefixime (Suprax) are partially man made (semi-synthetic) 3rd generation antibiotics that belong to the drug class called cephalosporins. Bacteria cannot survive without a cell wall, so cephalosporins prevent the bacteria from multiplying, which then prevents bacteria from forming the walls that surround them.

Other cephalosporin antibiotics include cephalexin (Keflex), cefuroxime (Zinacef), cefaclor (Ceclor), cefpodoxime (Vantin), and cefprozil (Cefzil).

Uses

Cefdinir and cefixime both are used for the treatment of a wide variety of bacterial infections , for example, infections of the:

• Middle ear (otitis media)
• Tonsils (tonsillitis)
• Throat (strep throat)
• Larynx (laryngitis)
• Sinuses (sinusitis)
• Bronchi (bronchitis)
• Lungs (pneumonia)
• Skin and other soft tissues

Cefdinir additional uses

Cefdinir also is used for the treatment of:

• Urinary tract infections
• Gonorrhea
• Acute bacterial bronchitis in patients with chronic obstructive pulmonary disease (COPD)

Cefdinir is not active against pseudomonas.

Cefdinir side effects

Cefdinir generally is well tolerated. The most common side effects are:

• Diarrhea or loose stools
• Nausea
• Abdominal pain
• Vaginal moniliasis
• Vaginitis
• Vomiting
• Rash
• Headache

Rare side effects include:

• Abnormal liver tests
• Allergic reactions
• Abnormal stool
• Constipation
• Dry mouth

Cefdinir may cause false test results with some tests for sugar in the urine.

Like most antibiotics, cefdinir may cause a condition called pseudomembranous colitis (Clostridium difficile colitis or C. diff), a potentially serious bacterial infection of the colon. Patients who develop signs of pseudomembranous colitis after starting cefdinir (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.

Persons who are allergic to the penicillin class of antibiotics, for example, amoxicillin, amoxicillin and clavulanic acid (Augmentin), which are related to cephalosporins, may or may not be allergic to cephalosporins.

Cefixime side effects

Common side effects of cefixime include:

• diarrhea,
• nausea,
• abdominal pain,
• vomiting and,
• skin rash.

Other side effects include:

• fever,
• joint pain,
• arthritis,
• abnormal liver tests,
• vaginitis,
• itching,
• headaches, and
• dizziness.

Cefdinir dosage

• Cefdinir is taken once or twice daily, depending on the type and severity of the infection.
• The capsules or suspension can be taken with or without food.
• Patients with advanced kidney disease may need to take lower doses to prevent accumulation of cefdinir since it is eliminated from the body by the kidneys.
• For adult infections the usual dose is 300 mg every 12 hours or 600 mg per day for 5-10 days depending on the nature and severity of the infection.
• The recommended dose for children 6 months to 12 years of age is 7 mg/kg every 12 hours or 14 mg/kg per day for 5-10 days depending on the type of infection.
• For most infections, once daily dosing is as effective as twice daily dosing, although once daily dosing has not been evaluated for the treatment of skin infections or pneumonia.

Cefixime dosage

• The recommended adult dose for middle ear infections, tonsillitis, sore throat, strep throat, and urinary tract infections is 400 mg once daily or divided and given as 200 mg every 12 hours.
• Pediatric patients (6 months and older) have a recommended dose of 8 mg/kg/day once daily or in two doses of 4/mg/kg every 12 hours.

Cefdinir drug and supplement interactions

• Aluminum or magnesium containing antacids reduce the absorption of cefdinir from the intestine. Separating the administration of cefdinir and such antacids by two hours prevents this interaction.
• Iron supplements also reduce the absorption of cefdinir. Separating the administration of cefdinir and iron supplements by two hours prevents this interaction. There have been reports of reddish stool in patients who have received cefdinir. This could be due to the formation of a chemical complex between cefdinir and iron in the stomach.

Cefixime drug and supplement interactions

• Probenecid (Benemid) may increase the blood concentration of cefixime by decreasing removal of cefixime by the kidney. This interaction sometimes is used to enhance the effect of cephalosporins.
• Combining cefixime with aminoglycosides (for example, tobramycin [TobraDex] produces additive bacterial killing effects but also may increase the risk of harmful effects to the kidney.)
• Exenatide (Byetta) may delay or reduce the absorption of cephalosporins. Cephalosporins should be administered one hour before exenatide.
• Cefixime may cause a false positive urine ketone test.

Cefdinir safety

• There are no adequate studies of cefdinir in pregnant women; however, studies in animals suggest no important effects on the fetus.
• Cefdinir is not secreted in human milk.

Cefixime safety

• Safety in pregnancy has not been established for cefixime. There are no adequate studies in pregnant women; however, studies in animals suggest no important effects on the fetus.
• Safety in nursing mothers has not been established. It is not known if cefixime is excreted in breast milk.